RACGP: Let’s ensure future of general practice care for all

The Royal Australian College of General Practitioners (RACGP) has urged the new federal Government to secure the future of general practice care by delivering on the college’s advocacy priorities.

It comes following Minister for Health and Aged Care Mark Butler speaking candidly about the “terrifying trend” of not enough future doctors opting for a career in general practice, leaving primary care “in worse shape than it’s been in the entire Medicare era.”

RACGP President Adj. Professor Karen Price said that GPs and general practice teams must be front of mind for the new Government.

“Minister Butler is spot on – the current generation of GPs are exhausted, and we don’t have enough future doctors choosing this career path,” she said.

“If primary care were a patient, it would be in dire need of an urgent trip to an emergency department due to multiple issues not being properly managed over many years. Medicare rebates for GP consultations haven’t kept pace with the cost of providing high-quality care, and the full impact of the rebate freeze stretching from 2013 to 2019 is still being keenly felt.

“While Medicare patient rebates increased on 1 July this year; it was only by a miserly 1.6%, which equates to 65 cents for a standard consult. When you consider the most recent inflation figure of 6.1% and the enormous costs practices are shouldering while managing patients during a pandemic you can see what we are up against.

“This is a key reason why it is proving so challenging to attract future doctors to general practice. Just 16% of medical students are considering general practice as their preferred specialty, and we also have a maldistribution of GPs that is disproportionately affecting rural and remote areas nation-wide. Without proper investment this will only worsen. More and more patients will struggle to find a GP taking bookings and others will no longer have their consultations bulk billed, which can result in patients delaying or avoiding care and having their health conditions deteriorate. Let’s not go down that path, because that is not what Australia is about. As a nation we are proud of universal healthcare, and we must future-proof it and protect it at all costs.”

The RACGP president said that the college’s advocacy priorities hold the key to helping communities in need across Australia.

“For too long, general practice has been taken for granted but there is no point crying over spilt milk and the RACGP has solutions at the ready,” she said.

“Greater investment in general practice care will result in better patient outcomes and attract more future doctors to the profession at a critical time. Ask any GP and they will tell you that they need more time and that includes time to speak to patients and get to the bottom of what is going on, particularly for mental health issues and people with complex chronic care needs.

“It is rare for patients to present with one clearly defined health problem in GP-land. More often, patients present with issues that require an expert GP familiar with multi-morbidity time to diagnose and treat. This is what some single disease presentation non-GP specialists may find hard to understand. We are experts in complexity, including multifaceted diagnosis and ongoing continuous management. GPs also understand care coordination and we have the responsibility of ensuring patients are not only getting the medicine that they need but also avoiding the medicine they do not need, or which may cause them harm.

“The complexity of GP presentations is why we are doubling down on our calls for a 10% increase to Medicare rebates for consultations lasting 20 to 40 minutes and 40 minutes plus as well as a brand new Medicare item for consults lasting more than hour. This has an impact on the inverse care law which as yet few international funding systems have adequately addressed. Boosting Medicare rebates will have a lasting impact on the health and wellbeing of people who need to have multiple health conditions carefully managed and result in fewer patients ending up in a hospital bed with a problem that could and should have been managed by their GP.

“Australia has an ageing population and improving the health and wellbeing of older people must be a priority. We are calling for a new service incentive payment to support older patients via a comprehensive health and frailty assessment or a GP management plan with at least one review.

“In the wake of the pandemic Australia is facing a mental health crisis and action is needed now. To help more patients get the support they need the Government should establish a new service incentive payment that supports several services including a mental health treatment plan. There are many patients for whom their GP presents as a safe, trusted, and confidential mental health practitioner and who don’t access any other health services. We must also ensure that people with a disability aren’t left behind, which is why a similar payment for a grouping of services including completion of NDIS documentation would make a real difference.

“We also can’t forget about telehealth, particularly phone consults. Some patients are not confident using video technology and others simply don’t have access to the digital infrastructure to make it work, including people in rural and remote areas where broadband strength and reliability just aren’t up to scratch. As a nation we can’t leave those people behind and that is why we want to reinstitute Medicare rebates for longer phone consultations and make them a permanent fixture of our telehealth system. Utilising technological solutions for human care requires some careful and rational thinking about social disadvantage.

“Last but not least, the Government must act to reduce the risk of patients ending up back in hospital again and again. A key step in achieving this is introducing additional support for patients to see their GP within seven days of an unplanned hospital admission. When you consider that approximately 718,000 readmissions to hospital occur each year it is easy to see why this would make such a difference for so many people.

“GPs and general practice teams have done a tremendous job during the pandemic, but we aren’t here to rest on our laurels. Primary care needs urgent attention, and we have a roadmap for the new Government to follow to make sure that all patients can access the care they need when they need it. The time is now.”

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